| NPI | 1255008694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 11702) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040907) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |